Science of Dry Skin
How to Care for Dry Skin
Published December 2021
Your skin is made up of multiple layers of cells and proteins, sugars, acids and lipids, or fats. In particular, ceramides and other lipids act as the glue that holds everything together. Together, these components create a barrier between the rest of your body and the outside world and help prevent water loss through the skin.
Sometimes external factors like heat or cold can strip your skin of some of the important molecules holding it together. This can cause weakness.
“When there is a weakness in the skin barrier, your skin can lose water, causing dry skin and accompanying symptoms of discomfort, itchiness, flaking and discoloration,” says Northwestern Medicine Dermatologist Raj J. Chovatiya, MD, PhD.
When your skin is weak, particles from the outside world can more easily get into it. This is why dry skin can feel itchy. Toxins, allergens or irritants activate your immune system, which can cause redness and swelling. They also activate your nervous system, triggering the sense of itch.
Dry Skin vs. Eczema
Xerosis is the medical term for dry skin. It is typically caused by external factors, such as your environment.
Eczema is a chronic inflammatory skin disease. It often presents with dry, itchy skin. People with eczema have problems with their skin barrier retaining moisture, oftentimes regardless of their environment. There can also be a genetic component to eczema. This means you have a higher risk of eczema if you have a family history of it.
Both people with xerosis and eczema can benefit from avoiding triggers.
Dry Skin Triggers
Excessive Use of Irritants
This includes using too much soap or using cleansers that contains harsh chemicals. Avoid repeated exposure to chemicals like alcohol and fragrances in personal hygiene products. Irritants can dry out the skin by stripping it of lipids.
Bad news for hot shower lovers: Long, hot showers can also strip your body of lipids and other molecules that help your skin seal in moisture.
Whether too hot or too cold, sudden and extreme changes of temperature can lead to dry skin.
Overheating in cold weather, for instance, bundling up and then sweating in cold temperatures, can also dry out your skin.
How to Combat Dry Skin
“Using cream and ointment-based emollients, which replace the lipids lost in your skin, can really amp up the skin barrier and seal in moisture,” says Dr. Chovatiya.
Emollients commonly include:
- Petrolatum (like in petroleum jelly)
- Mineral oil
If you have acne-prone skin, avoid oily substances that can clog your pores and lead to acne. Opt for a light, non-comedogenic (non-pore-clogging) moisturizer to keep your skin hydrated. Do not use heavy ointments like petroleum jelly in the places you tend to get acne.
Caring for Cuticles
It is common for dry skin to affect hands and fingertips.
“Your hands go through many wet/dry cycles throughout your day, which can make dry skin worse,” says Dr. Chovatiya.
For people with extremely dry cuticles and hands, especially in the winter months, Dr. Chovatiya recommends following this routine before bed:
- Soak your hands in warm water for 10 minutes.
- Pat (don’t scrub) your hands dry, leaving behind some moisture.
- Moisturize with an emollient moisturizer.
- Wear cotton gloves to lock in moisture and reduce the risk of greasy emollient getting everywhere.
- Avoid taking long, hot showers. Instead, take shorter showers with warm water.
- Use non-soap based cleansers. These use synthetic active ingredients instead of “surfactants” like sodium lauryl sulfate, which are typically found in soaps and can be harsh on your skin.
- Limit your exposure to alcohol-based hand-sanitizer. Instead, wash your hands with a non-soap based cleanser and use
- moisturize right after.
- Stop using a product if it causes skin irritation or a rash. Then, talk to your dermatologist.
Help or Hype? Hydration and Humidifiers
You may have heard that drinking water can help hydrate skin. While this is true, Dr. Chovatiya says: “You don’t need to overdo it with drinking water to help dry skin. Appropriately hydrating is an important part of overall health, not just skin health.”
Humidifiers can help in drier winter months when your body is constantly going between warm and cold temperatures. But, Dr. Chovatiya adds, “They may not directly fix an underlying issue of weakness in your skin barrier that can be more directly addressed with topical emollient products.”
Dry Skin Concerns for People of Color
“Dry skin in people of color is an emerging area of research,” says Dr. Chovatiya. “Our current understanding is that there may actually be a lower concentration of ceramides in certain skin types, including Black and Asian populations.”
This means that patients with skin of color may have more dryness than white patients. This is something dermatologists take into consideration when coming up with a treatment plan for dry skin. Diseases like eczema will also sometimes look different in skin of color than they do on white skin.
When to See a Dermatologist for Dry Skin
See your dermatologist if:
- Your skin is itchy
- Your dry skin symptoms come and go
- Your skin stays dry no matter how much you moisturize with an emollient
- Your skin is very sensitive to personal products
- Your skin is painful
- Your dry skin is causing mental health problems, such as anxiety, depression, sleep disturbances or suicidal ideation
“Remember no skin concern is too small for your dermatologist,” says Dr. Chovatiya. “We are here to help and treat not just your skin but you as a whole.”